What To Do With Frozen Embryos

November 28, 2006 - Tuesday
1:12 PM to (EST)
Guest Speakers: Dr. Jane Frederick
Huntington Reproductive Center

Categories
Frozen Embryos • IVF

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Deb	Welcome to our Online Education Session, hosted by The American Fertility Association and sponsored by Fertility Lifelines. As always, we will be starting at 8pm Eastern and run until 9pm Eastern. Thank you for your patience and we are glad you could join us.
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Corey_Whelan	just checking - I'm in the right place, yes?
tenayagirl2	hi corey- yes, i think so
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ash	hi Corey- that I met at the ball
Corey_Whelan	Well hi back!
Corey_Whelan	Does anyone here have frozen embryos left over that they're wondering what to do with?
ash	yes - we do have I believe 10 or more
Deb	Our guest tonight is Dr. Jane Frederick from Huntington Reproductive Center. Dr. Frederick was educated at USC and is board certified in Reproductive Endocrinolgy and Infertility as well as Ob/Gyn. She is a noted speaker and author
Deb	Welcome, Dr. Frederick!
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Deb	Tonight we are talking about what to do about frozen embryos. Dr. Frederick, can you set the stage for our discussion? What do we need to know and what questions should we be asking but might not know to ask.
jfrederick	Hello everyone! I hope tonight will be helpful to those of you who are interested in learning more about embryo donation.
Deb	I would like to welcome you all again. I am Deb Capone and I am your moderator tonight. If you need to talk with me directly just click on my name in the left hand column. I would especially like to thank Dr. Frederick for her time. So let the games begin!
jfrederick	As you know, there are many patients who have embryos that are stored in our IVF labs for many years throughout the country. Options for thier use include: keeping them stored longer, using them on yourself, destroying them, donation them to research, or donating them to another couple. I have advised my patients that although long term storage is an option, the longer the embryo is in storage, the more likely it will not survive the thaw and be a viable embryo. So I encourage patients to decide what to do with their embryos as soon as possible.
Corey_Whelan	how long can embryos be stored and still be viable, based on what we know now?
jfrederick	Many agencies, like Snowflakes Adoption Agency, have been set up to match a couple who has embryos to donate, with a recipient couple. Legal papers are needed to do this, as well as a home study like an adoption process. Many of my patients have been very successful in achieving a pregnancy through this process.
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Deb	Welcome Lori. We are here with Dr. Jane Frederick talking about frozen embryos. Feel free to jump in at any time!
ash	We were told that our embryos are stored in pairs. If we only want to use one of the two, can this be done?
jfrederick	Corey: The best time to utilize the stored embryos is within the first few years of cryopreservation. Most patients want to have their babies within a few years of each other anyway. The longer the embryo stays frozen, the decreased chance of successful thaw.
Deb	Dr. Frederick, is there a particular profile of patients who are successful with embryo adoption?
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ash	Dr. J>F: Can you quantify the length of time for viable embryos?
jfrederick	ash: The survival of the embryo depends on the quality of the embryo prior to freezing, as well as how long it was stored, and how many are stored. The age of the woman at the time of freezing is also critical, as success rates depend on the age of the patien.
Deb	Welcome, Att. Thanks for joining us!
Att	My Pleasure Deb..Thanks for this forum
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Att	My question is Does the Emboyo storage sometimes result in birth defects
jfrederick	Deb: The best chance for a successful embryo transfer would be 4-6 embryos thawed from a young patient, under age 35, within a few years of the initial freeze. However, I just helped a couple get pregnant with embryos that were stored from 7 years ago, in a very young donor patient.
Lori	I have spent so much money on meds for IUI and IVF and was a low responders and have given up.. Traditional adoption is very expensive. What is the average cost of adopting embryos. Do you know if there is anywhere to look to see if there are generous couples out there that would donate their unused embryos?
jfrederick	Att: We have been freezing and thawing embryos for the last 20 years, and have not seen an increase in birth defects due to the freezing technique. In the last 5 years, we have perfected the survival rate of embryos (usually 75% survive the thaw), so these embryos are much more likely to implant than embryos that were frozen longer.
jfrederick	Lori: I would suggest you inquire about the cost with the agencies : ie. Snowflakes. I have offered many of my needy patients a reduced rate for the frozen transfer utilizing the Snowflake Agency as a way to help out. Perhaps your specialist can do this as well.
Att	Thanks Dr. I have another question. How can we increase the chances of implantation during transfer. We will be doing an assisted hatching . IS there any other way to help implantation
Att	Sorry if my last question was out of scope of this forum
Corey_Whelan	I was under the impression that Snowflake only works with Christian married couples. Is this accurate?
Deb	Att, not to worry. We try and answer as many questions as possible.
jfrederick	Att: Assisted hatching can be very helpful in a frozen embryo transfer, as well as doing PGD (pre - implantation genetic diagnosis) if there are 6 - 8 embryos to choose from. Unfortunately, this extra procedure has a cost that prohibits most couples
Att	Thank you Dr Jane and Thank you Deb
jfrederick	Corey: I do not know of the restrictions for Snowflakes agency, but thier website can be very helpful. The National Embryo Donation Center in Knoxville, Tn can also be helpful.
Lori	Do you know the success rate of embryo adoptions being implanted in a 39 year old?
jfrederick	Corey: if you are considering a private donation out side of the agencies, I would caution you to be very careful about the legal implications involved with the transfer. Get a lawyer who has done this before - the agencies have this already in place when you apply
jfrederick	Lori: The success rate of frozen embryo transfer will depend on the number of embryos that are frozen, their quality at the time of freezing, and how long they have been frozen from this 39 year old person.
Lori	legal implications of private donation??? What type of legal implications.
jfrederick	Lori: It is helpful to work with a clinic who has a good success at frozen embryo transfer in their own IVF patients, as you will be getting the best outcome overall.
Att	Dr., My wife has had one ectopic in the past. Is there a risk of having the same in our present ivf cycle. Is there any thing the doctors can do to prevent it
Corey_Whelan	Thank you Dr. Frederick for your input
Deb	You can reach Snowflake at www.snowflakes.org and the National Center for Embryo Adoption at www.embryodonation.org if you are interested.
jfrederick	Lori: Each side should have legal counsel regarding the donation and regarding the responsibilities with the recipient. Just like an adoption, you want the donating couple to feel comfortable in their decision, and not come back to you 6 months later changing thier mind. Also, every state has a different legal take on embryo donation, and the agencies will know how to counsel you.
Deb	www.embryodonation.org has a lot of information on the legal issues surrounding embryo adoption.
jfrederick	Att: Ectopics are less likely to occur with an IVF cycle, because the embryos are placed in the uterus. If there is an abnormality in the tube like a hydrosalpinx, then the risk may be increased. You should ask your specialist regarding your particular case.
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Att	Thanks Dr.
Deb	We are at the halfway mark in our session tonight. This is the time to ask Dr. Frederick any questions you may have.
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Deb	It is also a good time to remind everyone to join The American Fertility Association as a "No Barriers" member-it is a great FREE resouce! Go to www.theafa.org and sign up when this session ends!
Deb	Welcome Sammi, thanks for joining us.
Sammi	My doc mentioned if my next try to produce eggs for IVF is not successful - he may have some embryos that could be donated to my husband and I from kind that have extra frozen embryos. I should have asked more questions but did not want to go down that road yet.... Would the other couple have meet us and fill out paper work????
jfrederick	I wish more of my couples would consider embryo adoption. If you go on my website, you can view an article I wrote on the subject "What to do with frozen embryos?" There are over 400,000 embryos stored in the USA, and only 2% are stored for donation.
Deb	Why do you think that is, Dr. Frederick?
Sammi	Sorry - hit send to quick - missed a few wordsMy doc mentioned if my next try to produce eggs for IVF is not successful - he may have some embryos that could be donated to me from loving couples that has extra frozen embryo. I should have asked more questions but did not want to go down that road yet.... So would the other couple have meet us and fill out paper work????
jfrederick	Deb: It is a difficult decision on what to do with remaining embryos. Many couples amy be unable to donate as they still consider this to be their unborn child. Snowflakes allows the donors to choose the adoptive parents, and gives them the option of staying in touch if both parties agree, so they can follow thier biological child's progress.
Deb	Aside from the legal and ethical questions surrounding embryo donation and adoption, what questions should we be asking our REs? Why do you think that more patients don't consider embryo adoption?
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jfrederick	Deb and Sammi: I think we need to spread the word about embryo donation as an option for frozen embryos. Unfortunately, many REI doctors don't know that these agencies are out there to help their patients, so referrals to the information is critical. Recently, the Federal Government as passed a measure earmarking $1 million to boost public awareness of embryo adoption
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Corey	I got bounced off and now I entered what appears to be an idle room. Do you see my name in the users section"
Deb	Are there hidden medical issues that need to be addressed and we should be aware of-either on the part of the prospective parents or from the donors?
amccloskey	Corey, I see you on the user list.
Deb	Welcome amccloskey. We are happy to have you.
Sammi	Is it possible that my doctor can really find a donor for me? Or do I need to use an agency?
Deb	Corey was the unfortunate victim of a techno-glitch! She is up and running now.
jfrederick	Deb: All parties should undergo medical testing for infectious diseases as required by the FDA for all IVF cycle. All parties should also undergo pschological and legal counsel regarding the impact on donating and/or recieving embryos. What should be told to the child regarding thier origins? We follow the guidelines in the adoption literature that says telling the child the truth is usually the best.
jfrederick	Sammi: I would ask your doctor is he/she has been successful in embryo donation before, as there are ethical and legal guidelines out there to follow. Consider this an adoption, and be sure to that the legal rules in your state are applied.
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Deb	As the parent of an child who was adopted, telling the truth is best-bit not always easy!
Deb	Welcome Carolynn. We are talking with Dr. Jane Frederick about embyro donation and adoption. Feel free to jump in with any questions you may have for her.
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jfrederick	Deb: I recommend that my coupled meet with an experienced mental health professional to discuss the implications of giving or recieving an embryo, and how it can affect their lives in the futre.
Deb	At what point in the family formation process is embryo donation considered?
jfrederick	Deb: I have recently been giving my article to all patients who are initiating an IVF cycle on what to do with frozen embryos. That way they are considering thier options even before the first embryo hits the ice!
Deb	Sounds like The AFA should have that article as well! ::rolleyes But that is a different subject all together!
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jfrederick	Deb: you are welcome to use it anytime: www.havingbabies.com is the website for my practise.
Deb	We have about ten minutes more of Dr. Frederick's time. This session has been incredibly informative and thought-provoking. We do have time for a few more questions for Dr. Frederick before I ask her to give us some final thoughts. Feel free to jump in.
tenayagirl2	There is also a wonderful organization called "Miracles Waiting" that provides much excellent information about embryo donation, including artcles from legal and psychological experts, free listings for donors, etc. the website is : http://www.miracleswaiting.org/membersonly3
Deb	Thanks so much for that infomation tenayagirl2. One of the benefits of these sessions is the support that is offered by all of you. Thanks.
Deb	Dr. Frederick, can you give us a brief summary, words of wisdom about frozen embryos, donation and adoption. We are pretty much out of time!
tenayagirl2	you are so welcome, deb. i know so many of us have benefitted from the helpful information you and Dr. frederick have provided. i know i have learned something new tonight!
jfrederick	Deb: Embryo donation has been very successful over the last few years. I know the Snowflakes program has supported over 80 couples in achieving a pregnacy in this way. I would hope that the word would get out to the doctors and to the IVF patients that this is a viable option, and hopefully the couples who are getting pre-treatment counseling on this option will feel more comfortable when the time arises. I would caution all parties to get psychological and legal counseling prior to accepting a donation as each state has their own issues. I hope this has helped you
Deb	I would like to thank all of you for your participation tonight and remind you that we are here EVERY Tuesday evening from 8pm Eastern until 9pm. You can get more information about this topic from Dr. Frederick's website: www.havingbabies.com and from www.theafa.org as well as the other resources mentioned tonight. But most of all, I want to thank you, Dr. Frederick for you time and for sharing your expertise with us.
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Deb	Please join us next week-same bat time, same bat channel (and now you know my age!).
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jfrederick	Deb: thanks for organizing this forum. Your organization is always pro-active in the field, and we appreciate you.
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Deb	Good night, everyone! Thanks again.
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What To Do With Frozen Embryos

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